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There is destruction of the joint surfaces, with or without significant bone deformity.
The cruciate and/or collateral ligaments do not stabilize the knee joint.
The ligaments are inadequate and/or the musculature is weak.
Revision is required of a failed prosthesis where there has been gross instability, with or without bone loss or inadequate soft tissue.

Device Description

This Special 510(k) submission is a line extension intended to add offset adapters to the Howmedica Osteonics® Modular Rotating Hinge Knee.

AI/ML Overview

This submission, K060360, describes a line extension for the Howmedica Osteonics® Modular Rotating Hinge Knee, introducing offset adapters. This is a Special 510(k) submission, meaning it relies on a comparison to substantially equivalent predicate devices. Due to the nature of a Special 510(k) for a line extension of an existing device, a full-scale clinical study with acceptance criteria and device performance as typically seen for novel devices is not provided. Instead, the submission focuses on demonstrating equivalent mechanical properties to the predicate devices.

Here's an analysis based on the provided document:

1. Table of Acceptance Criteria and Reported Device Performance:

Acceptance Criteria (Inferred)	Reported Device Performance
Mechanical Properties comparable to predicate devices.	"An engineering analysis demonstrated comparable mechanical properties to the predicate components and substantial equivalence to these devices." (This is the primary performance claim for this Special 510(k), as it's a line extension for offset adapters.)
No alteration to the Intended Use of the predicate devices.	"The combination of the predicate systems as cleared in the Howmedica Osteonics® Modular Rotating Hinge Knee and Howmedica Total Stabilizer Knee Components 510(k) premarket notifications does not alter the intended use." and "The subject and predicate devices are single use, sterile knee replacement systems. The indications for use for the Howmedica Osteonics® Modular Rotating Hinge Knee with Offset Adapters are provided below." (The listed indications for use are identical to those of the predicate devices, implying no change to intended use or patient population).
Same design, materials, and operational principle as predicate devices.	"The subject Howmedica Osteonics® Modular Rotating Hinge Knee with Offset Adapters share the same design, intended use, performance, materials, and operational principle as that of the currently available Howmedica Osteonics® Modular Rotating Hinge Knee and Howmedica Total Stabilizer Knee Components."

2. Sample Size Used for the Test Set and Data Provenance:

This document describes an engineering analysis, not a clinical study involving human subjects or a test set in the traditional sense for evaluating diagnostic or predictive performance. Therefore, there is no mention of a "test set" sample size or data provenance (country of origin, retrospective/prospective). The "test set" would implicitly refer to the physical components of the offset adapters undergoing mechanical testing. The specific number of components tested is not detailed in this summary.

3. Number of Experts Used to Establish the Ground Truth for the Test Set and Qualifications of those Experts:

This information is not applicable. The "ground truth" for an engineering analysis focused on mechanical properties would be established through established scientific principles, standardized testing procedures, and validated measurement equipment, not through expert consensus in a clinical context.

4. Adjudication Method for the Test Set:

This information is not applicable, as it pertains to clinical studies involving human assessments or diagnostic outcomes.

5. If a Multi-Reader Multi-Case (MRMC) Comparative Effectiveness Study was done, If so, what was the effect size of how much human readers improve with AI vs without AI assistance:

This is not applicable. The device is a mechanical knee implant, not an AI-powered diagnostic or assistive tool for human readers.

6. If a Standalone (i.e. algorithm only without human-in-the-loop performance) was done:

This is not applicable. The device is a mechanical implant.

7. The Type of Ground Truth Used:

For the engineering analysis, the "ground truth" would be the physical and mechanical properties of the materials and component designs, measured and quantified according to industry standards for orthopedic implants. This would involve stress tests, fatigue tests, and other biomechanical evaluations to ensure the new offset adapters meet the same performance criteria as the existing predicate devices.

8. The Sample Size for the Training Set:

This information is not applicable. There is no "training set" as this is not an AI/machine learning study. The development of the offset adapters would have involved engineering design, material selection, and manufacturing processes, but not a data-driven training set in the computational sense.

9. How the Ground Truth for the Training Set was Established:

This information is not applicable. As explained above, there is no training set. The "ground truth" for the design and manufacturing of the device relies on established engineering principles, material science, and regulatory standards for medical device safety and efficacy.

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